Adverse maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism

Mei-Fang Li; Li Ma; Tian-Pei Yu; Yue Zhu; Ming-Yun Chen; Yun Liu; Lian-Xi Li

doi:10.1016/j.diabres.2020.108085

Adverse maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism

Diabetes Res Clin Pract. 2020 Mar:161:108085. doi: 10.1016/j.diabres.2020.108085. Epub 2020 Feb 13.

Authors

Mei-Fang Li¹, Li Ma², Tian-Pei Yu³, Yue Zhu⁴, Ming-Yun Chen⁴, Yun Liu⁵, Lian-Xi Li⁶

Affiliations

¹ Department of Emergency, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China.
² Department of Obstetrics and Gynecology, Shanghai Clinical Center for Severe Maternal Rescue, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China.
³ Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Affiliated Hospital of Southeast University, Jiangsu, China.
⁴ Department of Endocrinology & Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China.
⁵ Department of Information, The First Affiliated Hospital of Nanjing Medical University, Department of Medical Information, School of Biomedical Engineering and Informatics, Nanjing Medical University, Jiangsu, China.
⁶ Department of Endocrinology & Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China. Electronic address: lilx@sjtu.edu.cn.

PMID: 32061817
DOI: 10.1016/j.diabres.2020.108085

Abstract

Aims: To assess the prevalence and risk of adverse perinatal outcomes in pregnant women with abnormal glucose metabolism.

Methods: 3269 Chinese pregnant women with singleton delivery were studied, including 787 diagnosed as gestational diabetes mellitus (GDM), 115 pregnancy with diabetes (PWD), and 2367 normal glucose tolerance (NGT). The prevalence and risk of adverse maternal and fetal outcomes were compared and assessed among the three groups, and the related risk factors of the glucose metabolism for adverse pregnancy outcomes were evaluated by binary logistic regression.

Results: Compared to NGT, maternal GDM and PWD faced increased risk of adverse perinatal outcomes such as pregnancy-induced hypertension (odds ratio (OR) 1.78 [95% confidence interval (CI): 1.17-2.72]; 4.31 [95% CI: 2.32-7.98]), low birth weight (OR 1.51 [95% CI: 1.01-2.28]; 4.05 [95% CI: 2.17-7.55]). And PWD group exhibited remarkably higher risk for preterm delivery (OR 2.88 [95% CI: 1.68-4.94]) and stillbirth (OR 7.78 [95% CI: 2.44-24.84]) than other two groups. The increased fasting insulin and glycated hemoglobin A1c were successively independent risk factors for maternal and neonatal adverse outcomes.

Conclusions: Gestational abnormal glucose metabolism is associated with the remarkably increased risk of adverse perinatal outcomes, and PWD has higher risk of adverse perinatal outcomes than GDM.

Keywords: Adverse maternal outcomes; Adverse neonatal outcomes; Gestational abnormal glucose metabolism.

MeSH terms

Adult
Blood Glucose / metabolism*
Diabetes, Gestational / diagnosis*
Female
Humans
Infant, Newborn
Pregnancy
Pregnancy Complications / epidemiology*
Pregnancy in Diabetics / physiopathology*

Substances

Blood Glucose